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Menopausal transition in multiple sclerosis: relationship with disease activity and brain volume measurements

BACKGROUND: Recent evidence has shown a significant association between menopause and multiple sclerosis (MS) progression. This study investigated the possible role of menopause in influencing MS from clinical and neuroradiological perspectives. Notably, the possible association between menopause an...

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Autores principales: Lorefice, Lorena, Fenu, Giuseppe, Fronza, Marzia, Murgia, Federica, Frau, Jessica, Coghe, Giancarlo, Barracciu, Maria Antonietta, Atzori, Luigi, Angioni, Stefano, Cocco, Eleonora
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10434500/
https://www.ncbi.nlm.nih.gov/pubmed/37602270
http://dx.doi.org/10.3389/fneur.2023.1251667
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author Lorefice, Lorena
Fenu, Giuseppe
Fronza, Marzia
Murgia, Federica
Frau, Jessica
Coghe, Giancarlo
Barracciu, Maria Antonietta
Atzori, Luigi
Angioni, Stefano
Cocco, Eleonora
author_facet Lorefice, Lorena
Fenu, Giuseppe
Fronza, Marzia
Murgia, Federica
Frau, Jessica
Coghe, Giancarlo
Barracciu, Maria Antonietta
Atzori, Luigi
Angioni, Stefano
Cocco, Eleonora
author_sort Lorefice, Lorena
collection PubMed
description BACKGROUND: Recent evidence has shown a significant association between menopause and multiple sclerosis (MS) progression. This study investigated the possible role of menopause in influencing MS from clinical and neuroradiological perspectives. Notably, the possible association between menopause and brain atrophy has been evaluated. MATERIALS AND METHODS: This study included women with MS whose ages ranged from 45 to 55 years. Demographic and clinical characteristics were collected, and the reproductive phase was defined as non-menopausal or menopausal based on the final menstrual period. Thus, MS activity over the past year was reported as the annualised relapse rate (ARR), and MRI activity (defined as new T2 lesions and/or the presence of gadolinium-enhancing lesions at the last MRI assessment in comparison with the MRI performed within the previous 12 months) were compared between non-menopausal women (non-MW) and menopausal women (MW). Volume measurements of the whole brain (WB), white matter (WM), grey matter (GM), and cortical GM were estimated using the SIENAX software, and the possible relationship with menopausal status was assessed by regression analysis. RESULTS: The study included 147 women with MS. Eighty-four (57.1%) were MW, with a mean age of 48.5 ± 4.3 years at menopause onset and a mean duration of menopause of 4.1 ± 1.1 years. When compared for ARR, MW reported a lower rate than the non-MW (ARR of 0.29 ± 0.4 vs. 0.52 ± 0.5; p < 0.01). MRI activity was observed in 13.1% of MW and 20.6% of non-MW (p = 0.03). Lower cortical GM volumes (578.1 ± 40.4 mL in MW vs. 596.9 ± 35.8 mL in non-MW; p < 0.01) have also been reported. Finally, multivariate analysis showed a significant association of lower ARR (p = 0.001) and cortical GM volume (p = 0.002) with menopausal status after correction for chronological age and other variables. DISCUSSION: Menopause may be an adverse prognostic factor of MS. Our preliminary results suggest that menopause may facilitate cortical GM atrophy, probably due to a decline in the neuroprotective effects of estrogen, with negative effects on MS evolution.
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spelling pubmed-104345002023-08-18 Menopausal transition in multiple sclerosis: relationship with disease activity and brain volume measurements Lorefice, Lorena Fenu, Giuseppe Fronza, Marzia Murgia, Federica Frau, Jessica Coghe, Giancarlo Barracciu, Maria Antonietta Atzori, Luigi Angioni, Stefano Cocco, Eleonora Front Neurol Neurology BACKGROUND: Recent evidence has shown a significant association between menopause and multiple sclerosis (MS) progression. This study investigated the possible role of menopause in influencing MS from clinical and neuroradiological perspectives. Notably, the possible association between menopause and brain atrophy has been evaluated. MATERIALS AND METHODS: This study included women with MS whose ages ranged from 45 to 55 years. Demographic and clinical characteristics were collected, and the reproductive phase was defined as non-menopausal or menopausal based on the final menstrual period. Thus, MS activity over the past year was reported as the annualised relapse rate (ARR), and MRI activity (defined as new T2 lesions and/or the presence of gadolinium-enhancing lesions at the last MRI assessment in comparison with the MRI performed within the previous 12 months) were compared between non-menopausal women (non-MW) and menopausal women (MW). Volume measurements of the whole brain (WB), white matter (WM), grey matter (GM), and cortical GM were estimated using the SIENAX software, and the possible relationship with menopausal status was assessed by regression analysis. RESULTS: The study included 147 women with MS. Eighty-four (57.1%) were MW, with a mean age of 48.5 ± 4.3 years at menopause onset and a mean duration of menopause of 4.1 ± 1.1 years. When compared for ARR, MW reported a lower rate than the non-MW (ARR of 0.29 ± 0.4 vs. 0.52 ± 0.5; p < 0.01). MRI activity was observed in 13.1% of MW and 20.6% of non-MW (p = 0.03). Lower cortical GM volumes (578.1 ± 40.4 mL in MW vs. 596.9 ± 35.8 mL in non-MW; p < 0.01) have also been reported. Finally, multivariate analysis showed a significant association of lower ARR (p = 0.001) and cortical GM volume (p = 0.002) with menopausal status after correction for chronological age and other variables. DISCUSSION: Menopause may be an adverse prognostic factor of MS. Our preliminary results suggest that menopause may facilitate cortical GM atrophy, probably due to a decline in the neuroprotective effects of estrogen, with negative effects on MS evolution. Frontiers Media S.A. 2023-08-03 /pmc/articles/PMC10434500/ /pubmed/37602270 http://dx.doi.org/10.3389/fneur.2023.1251667 Text en Copyright © 2023 Lorefice, Fenu, Fronza, Murgia, Frau, Coghe, Barracciu, Atzori, Angioni and Cocco. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Lorefice, Lorena
Fenu, Giuseppe
Fronza, Marzia
Murgia, Federica
Frau, Jessica
Coghe, Giancarlo
Barracciu, Maria Antonietta
Atzori, Luigi
Angioni, Stefano
Cocco, Eleonora
Menopausal transition in multiple sclerosis: relationship with disease activity and brain volume measurements
title Menopausal transition in multiple sclerosis: relationship with disease activity and brain volume measurements
title_full Menopausal transition in multiple sclerosis: relationship with disease activity and brain volume measurements
title_fullStr Menopausal transition in multiple sclerosis: relationship with disease activity and brain volume measurements
title_full_unstemmed Menopausal transition in multiple sclerosis: relationship with disease activity and brain volume measurements
title_short Menopausal transition in multiple sclerosis: relationship with disease activity and brain volume measurements
title_sort menopausal transition in multiple sclerosis: relationship with disease activity and brain volume measurements
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10434500/
https://www.ncbi.nlm.nih.gov/pubmed/37602270
http://dx.doi.org/10.3389/fneur.2023.1251667
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